scholarly journals Successful aggressive radical surgery after neoadjuvant chemotherapy for locally advanced intrahepatic cholangiocarcinoma

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e471-e472
Author(s):  
S. Jo ◽  
S. Song ◽  
N. Myung
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Intrahepatic Cholangiocarcinoma ◽  
Radical Surgery ◽  
Locally Advanced

Neoadjuvant chemotherapy followed by radical surgery in locally advanced vulvar carcinoma: a single-institution experience

2021 ◽  
pp. 030089162110276
Author(s):  
Adorni Marco ◽  
Bazzurini Luca ◽  
Lissoni Andrea Alberto ◽  
Vecchione Francesca ◽  
Negri Serena ◽  
...  
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Partial Response ◽  
Vulvar Cancer ◽  
Elderly Women ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Complete Response ◽  
Tumor Burden ◽  
Clinical Response Rate

Background: Squamous cell carcinoma of the vulva is a rare malignancy that affects elderly women. About one-third of vulvar cancers are diagnosed in an advanced stage, requiring extensive surgery. Neoadjuvant chemotherapy (NACT) has been introduced to reduce local tumor burden. In this retrospective study, we analyze the efficacy and toxicity of NACT followed by radical surgery. Methods: Patients with locally advanced vulvar cancer (LAVC) treated at our institution with neoadjuvant platinum and paclitaxel-based chemotherapy ± ifosfamide followed by surgery at our institution were retrospectively identified. Results: Fourteen patients (93%) completed NACT with tolerable toxicities (G3–G4 toxicity: 30%). Thirteen patients (87%) underwent surgery. The overall clinical response rate on vulvar disease was 66% (20% complete response, 46% partial response), confirmed by histopathologic analysis, while on inguinal lymph nodes it was 69% (23% complete response, 46% partial response). At the pathologic examination, all patients had negative surgical margins. Three out of 9 patients (33%) with lesions infiltrating the urethral meatus and 4 patients out of 7 (57%) with anal involvement did not require urethral amputation or colostomy, respectively, after NACT. No severe postoperative complications were described. Overall survival at 5 years was 60%, and median overall survival was 76 months. Conclusion: NACT followed by surgery in locally advanced vulvar cancer is well tolerated and allows surgical modulation.

Radical Surgery After Neoadjuvant Chemotherapy for Locally Advanced Neuroendocrine Cancer of the Cervix

2021 ◽  
Vol 41 (9) ◽  
pp. 4431-4438
Author(s):  
GIUSEPPE CARUSO ◽  
INNOCENZA PALAIA ◽  
VIOLANTE DI DONATO ◽  
ANGELINA PERNAZZA ◽  
ROBERTA GALLO ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Neuroendocrine Cancer ◽  
Cancer Of The Cervix

Neoadjuvant Chemotherapy Followed by Radical Surgery Versus Concomitant Chemotherapy and Radiotherapy in Patients With Stage IB2, IIA, or IIB Squamous Cervical Cancer: A Randomized Controlled Trial

2018 ◽  
Vol 36 (16) ◽  
pp. 1548-1555 ◽  
Author(s):  
Sudeep Gupta ◽  
Amita Maheshwari ◽  
Pallavi Parab ◽  
Umesh Mahantshetty ◽  
Rohini Hawaldar ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Controlled Trial ◽  
Locally Advanced ◽  
Concomitant Chemotherapy ◽  
Randomized Controlled ◽  
Surgery Group ◽  
Squamous Cervical Cancer ◽  
Concomitant Chemoradiation

Purpose We compared the efficacy and toxicity of neoadjuvant chemotherapy followed by radical surgery versus standard cisplatin-based chemoradiation in patients with locally advanced squamous cervical cancer. Patients and Methods This was a single-center, phase III, randomized controlled trial ( ClinicalTrials.gov identifier: NCT00193739). Eligible patients were between 18 and 65 years old and had stage IB2, IIA, or IIB squamous cervical cancer. They were randomly assigned, after stratification by stage, to receive either three cycles of neoadjuvant chemotherapy using paclitaxel and carboplatin once every 3 weeks followed by radical hysterectomy or standard radiotherapy with concomitant cisplatin once every week for 5 weeks. Patients in the neoadjuvant group received postoperative adjuvant radiation or concomitant chemotherapy and radiotherapy, if indicated. The primary end point was disease-free survival (DFS), defined as survival without relapse or death related to cancer, and secondary end points included overall survival and toxicity. Results Between September 2003 and February 2015, 635 patients were randomly assigned, of whom 633 (316 patients in the neoadjuvant chemotherapy plus surgery group and 317 patients in the concomitant chemoradiation group) were included in the final analysis, with a median follow-up time of 58.5 months. The 5-year DFS in the neoadjuvant chemotherapy plus surgery group was 69.3% compared with 76.7% in the concomitant chemoradiation group (hazard ratio, 1.38; 95% CI, 1.02 to 1.87; P = .038), whereas the corresponding 5-year OS rates were 75.4% and 74.7%, respectively (hazard ratio, 1.025; 95% CI, 0.752 to 1.398; P = .87). The delayed toxicities at 24 months or later after treatment completion in the neoadjuvant chemotherapy plus surgery group versus the concomitant chemoradiation group were rectal (2.2% v 3.5%, respectively), bladder (1.6% v 3.5%, respectively), and vaginal (12.0% v 25.6%, respectively). Conclusion Cisplatin-based concomitant chemoradiation resulted in superior DFS compared with neoadjuvant chemotherapy followed by radical surgery in locally advanced cervical cancer.

High-dose cisplatin and bleomycin neoadjuvant chemotherapy plus radical surgery in locally advanced cervical carcinoma: A preliminary report

1991 ◽  
Vol 41 (3) ◽  
pp. 212-216 ◽  
Author(s):  
Pierluigi Benedetti Panici ◽  
Stefano Greggi ◽  
Giovanni Scambia ◽  
Guglielmo Ragusa ◽  
Gabriela Baiocchi ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Cervical Carcinoma ◽  
Preliminary Report ◽  
Radical Surgery ◽  
Locally Advanced ◽  
High Dose ◽  
Advanced Cervical Carcinoma

Neoadjuvant chemotherapy plus radical surgery in locally advanced cervical cancer during pregnancy: a case report

2007 ◽  
Vol 197 (4) ◽  
pp. e5-e6 ◽  
Author(s):  
Innocenza Palaia ◽  
Milena Pernice ◽  
Marialida Graziano ◽  
Filippo Bellati ◽  
Pierluigi Benedetti Panici
Keyword(s):  
Cervical Cancer ◽  
Case Report ◽  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer

Paclitaxel, ifosfamide, and cisplatin regimen as neoadjuvant chemotherapy in young women with locally advanced squamous cervical cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5587-5587
Author(s):  
M. Marinaccio ◽  
E. De Marino ◽  
E. Mele ◽  
R. Catacchio ◽  
C. Pellegrino ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Young Women ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Young Patients ◽  
Progression Free Survival ◽  
Advanced Cervical Cancer ◽  
Curative Radiotherapy

5587 Background: Chemoradiotherapy is the standard treatment of advanced cervical cancer. Neoadjuvant chemotherapy (NAC) may represent an alternative for locally advanced cervical cancer (LACC).This study was undertaken to evaluate the efficacy of NAC in young patients with squamous LACC. Methods: Since 2000 to 2008, 61 pts (mean age 43 yrs) with squamous LACC were treated with NAC and afterwards evaluated for radical surgery. Eligibility included proven histologically diagnosis of squamous cervical carcinoma, FIGO stage IB2/IIA>4cm/IIB, measurable disease, ECOG PS 0–2, no prior therapy and age under 49 years. All patients received TIP regimen (cisplatin 50 mg/m2 i.v. day 1, paclitaxel 175 mg/m2 over 3 hrs i.v.day1, ifosfamide 5,000 mg/m2 plus mesna 6,000 mg/m2 over 24 hrs i.v. day 1–2). Each cycle was repeated every 21 days. Patients were evaluated 4–6 weeks after the completion of the third cycle with the purpose to perform radical surgery according to clinical response. Results: 35pts (57.4%) were stage IB2; 9 (14.7%) were IIA >4cm; and 17 (27.9%) were IIB. After restaging the clinical results were: CR = 4/61 (6.6%), PR = 51/61 (83.6%); no response = 5/61 (8.2%); progression = 1/61 (1.6%). A total of 55 pts (90.1%) were eligible for surgery; 6/61 pts (9.8%) were submitted to curative radiotherapy (until 2004) or chemoradiotherapy. Pathological responses after surgery were: 4 pCR (7.3%); 46 pPR (83.6%); and 5 (9.1%) pPR with presence of positive surgical margins or metastatic lymph nodes. Out of 55 pts, 50 received 2 cycles of TIP regimen as a consolidation therapy before follow-up; 5 pts with incomplete pPR underwent radio/chemoradiotherapy. After NAC an overall downstaging of LACC was obtained in 50/61 pts (82.0%). In this group of pts at the median follow-up of 42 months (range 4–98) updated as of December 2008, the 3-years progression-free survival and overall survival are 85.9% and 82.0%, respectively. Conclusions: Our results indicate that TIP regimen-based NAC is an attractive option in young women with squamous LACC (IB2,IIA >4cm, IIB) that strongly desire surgery.The rate of patients with a prolonged remission of disease (82.0%) suggests that the clinical benefit of TIP regimen-based NAC followed by surgery may be comparable to chemoradiotherapy. No significant financial relationships to disclose.

Neoadjuvant chemotherapy plus radical surgery followed by chemotherapy in locally advanced cervical cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5093-5093
Author(s):  
Roberto Angioli ◽  
Francesco Plotti ◽  
Corrado Terranova ◽  
Michela Angelucci ◽  
Irma Oronzi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Platinum Based Chemotherapy ◽  
Node Metastases

5093 Background: The aim of this study is to evaluate the efficacy, in terms of overall survival and progression free survival, and safety of adjuvant chemotherapy after neoadjuvant chemotherapy followed by radical surgery both in patients with and without node metastases. Methods: Between June 2000 to May 2007, all patients with diagnosis of locally advanced cervical cancer referred to the Division of Gynecologic Oncology of the University Campus Bio-Medico of Rome were elegible for this protocol.All enrolled patients received 3 cycles of platinum-based chemotherapy every 3 weeks according to the scheme cisplatin 100 mg/mq and paclitaxel 175 mg/mq. After neoadjuvant chemotherapy all patients with stable or progression to treatment were excluded from the protocol, all other were submitted classical radical hysterectomy and bilateral systematic pelvic lymph node dissection, and after to adjuvant treatment with 6 cycles of platinum based chemotherapy with cisplatin 100 mg/mq and paclitaxel 175 mg/mq. Results: 110 patients with local advanced cervical cancer received the treatment with neoadjuvant chemotherapy followed by radical surgery and adjuvant chemotherapy.Our study focused on clinical and operative data , in terms of overall survival and disease free survival at 5 and 3 years. 5-year OS of our series was 78% at five years and 86% at 3-years, with encouraging results also in subgroup with and without node mestastases. Conclusions: The adjuvant chemotherapy regimen after neoadjuvant chemotherapy and radical surgery rappresents a valid treatment option for patients with locally advanced cervical cancer without lymph node involvement, both in terms of overall survival than in terms of disease-free interval, the results have also confirmed the validity of this approach in lymph node metastases, with a complication rate lower than the standard radio-chemotherapy regime.

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